Enhancement of thrombolysis with tissue‐type plasminogen activator by pretreatment with heparin
作者:
BOJAN,
CERCEK ALLAN,
LEW HANOCH,
HOD JULIANA,
YANO NAGENDRA,
REDDY WILLIAM,
期刊:
Circulation
(OVID Available online 1986)
卷期:
Volume 74,
issue 3
页码: 583-587
ISSN:0009-7322
年代: 1986
出版商: OVID
数据来源: OVID
摘要:
ABSTRACTThe effect of pretreatment with heparin on lysis of arterial thrombi by tissue-type plasminogen activator (rt-PA) was studied in 19 dogs. Copper coil-induced carotid artery thrombi were weighed, inserted into the femoral arteries, and exposed to a 15 min infusion of rt-PA at 10, μg/kg/min either with (n = 6 thrombi) or without pretreatment with a 200 unit/kg bolus of heparin (n = 6 thrombi). The infusion of rt-PA without pretreatment reduced the thrombus weight by 27.6 ± 7.4%, while infusion of rt-PA with pretreatment reduced it by 79.1 ± 12.3% (p < .0001). To test the hypothesis that heparin enhanced thrombolysis by preventing continued incorporation of new fibrin into the thrombus during thrombolysis we repeated the experiments using pretreatment with 8 U/kg of ancrod, which rapidly depletes fibrinogen. Pretreatment with ancrod (n = 6 thrombi) depleted fibrinogen and enhanced the lytic effect of rt-PA to a similar degree as pretreatment with heparin, resulting in a 67.6 ± 12.3% (NS) decrease in thrombus weight. We conclude that heparin significantly enhances the thrombolytic effect of rt-PA, probably by preventing new fibrin formation and its incorporation into the thrombus during lysis.
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